New Polio-like illness emerging in the United States

Posted on October 19, 2018 at 1:25 pm.

Acute flaccid myelitis (AFM) is an illness characterized by acute onset of flaccid limb weakness and magnetic resonance imaging (MRI) showing lesions in the gray matter of the spinal cord. AFM has been under investigation by health departments and the Centers for Disease Control and Prevention (CDC) for the past 4 years. Surveillance has shown that AFM cases generally peak in the months of September and October. A biennial pattern has been observed, with the majority of cases reported in 2014 and 2016, and smaller numbers reported in 2015 and 2017.

AFM appears to start with a respiratory or gastrointestinal illness about 1 week before limb weakness onset. Pain in the neck or back often directly precedes weakness in one or more limbs, and cranial nerve findings such as slurred speech, difficulty swallowing, and eyelid or facial droop may occur. On exam, the weak limb(s) displays poor tone and diminished reflexes.

Since AFM is a relatively new condition, CDC and the Louisiana Department of Health (LDH) are investigating all patients to help us better understand the spectrum of illness, and all possible causes, risk factors, and outcomes for AFM. CDC does not know what causes most AFM cases, despite extensive lab testing. There are several possible causes of AFM, such as viruses (e.g., poliovirus, non-polio enteroviruses such as EV-A71, adenoviruses, and West Nile Virus), environmental toxins, and genetic disorders. To date, all of the AFM cases have tested NEGATIVE for poliovirus.

As of October 16, 2018, CDC has confirmed 62 cases of AFM in 22 states. Out of the 62 cases, 58 have been in the pediatric population (individuals less than 18 years old). Even with the increase in cases, AFM remains very rare (less than 1 in a million).

If your child begins to develop weakness in an arm or leg, or slurred speech, difficulty swallowing, eyelid drooping or facial drooping – please contact us and make an appointment. At present there are no known cases in the Baton Rouge area.